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(Circulation. 1969;39:655.)
© 1969 American Heart Association, Inc.

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The Dicrotic Arterial Pulse

GORDON A. EWY M.D.¹; JORGE C. RIOS M.D.¹; FRANK I. MARCUS M.D.¹

¹ From the Georgetown University School of Medicine, Department of Medicine, Division of Cardiology, District of Columbia General Hospital, and the George Washington University School of Medicine, George Washington University Medical Division, District of Columbia General Hospital, Washington, D. C.

The study consisted of observations on nine male patients with palpable dicrotic as evidenced by cardiomegaly and the presence of prominent atrial and ventricular diastolic gallop sounds. Most of these patients were diagnosed as having primary myocardial disease.

The indirect carotid pulse was characterized by a single systolic wave, a low dicrotic notch, and a large dicrotic wave. The direct brachial arterial pressure pulse had a similar configuration with a shortened ejection time index. The hemodynamic data on these patients was characterized by low cardiac output, low stroke volume, elevated pulmonary arterial wedge pressures, and high total systemic resistance. From these observations we conclude that the presence of a marked dicrotic pulse in afebrile patients at rest may indicate severe functional impairment of the myocardium.

Key Words: Dicrotic notch • Primary myocardial disease • Dicrotic wave • Hemodynamic data • Peripheral vascular resistance